Dr. Lee's Alzheimer's and Antipsychotic lecture Flashcards Preview

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Flashcards in Dr. Lee's Alzheimer's and Antipsychotic lecture Deck (68)
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1

What is the term for a drop in cognitive function from a prior level?

mild cognitive impairment

2

What is mild cognitive impairment plus a loss in the ability to care for oneself?

Dementia

3

What is required to make the diagnosis of dementia?

A detailed history about prior levels of function.

4

Is MCI treated with any medication? Dementia?

No and yes

5

What rank in cause of death is Alzheimer's?

6th in the USA

6

What gene increases the risk of Alzheimer's?

Apolipoprotein E (APOE). Varient E4 increases the risk. A single copy increases risk 3-fold, homozygous e4 increases risk 8-12 fold.

7

What other family history increases the risk of Alzheimer's?

Cardiovascular disease history in the family

8

What lifestyles/disease states increase the risk of Alzheimer's?

Cardiovascular disease in middle age
Smoking
Midlife obesity
Midlife hypertension
midlife hyperlipidemia
diabetes

9

What increases cognitive reserve to stave off dementia?

Education

10

What maintains cognitive reserve?

social engagement

11

What is the most common form of dementia (60-80%)?

Alzheimer's

12

In normal aging, neurons are...

preserved

13

In normal aging, brain mass is...

preserved

14

In normal aging, synaptic connections are...

lost. this is shown by processing speed decrease and abstract concept linkage decrease.

15

How are storage of memories affected by normal aging?

Takes longer to develop memories

16

How are retrieval of memories affected by normal aging?

Preserved, but retrieval process is slower.

17

How is thinking and reasoning affected by normal aging?

Preserved

18

What part of the brain is affected early in Alzheimers compared to normal aging?

The hippocampus (memory)

19

What other area of the brain are different in Alzheimer's compared to normal aging?

- Language is affected
- The ventricles start to enlarge
- As more cells die, the sulci get wider

20

What areas of the brain are rich in cholinergic neurons?

Early:
Memory
Language
Later:
Reasoning and understanding
Disinhibition and behavioral problems

21

What histology will you see in Alzheimer's Disease?

Amyloid beta peptide insoluble plagues accumulated on the outside of cells.

22

What protein is formed with B-secretase and y-secretase?

Amyloid-beta42.

23

What protein is formed from alpha-secretase and y-secretase?

B-amyloid40.

24

Is amyloid-beta42 or beta-amyloid40 more plaque-forming?

Amyloid-beta 42 is more plaque-forming, while 40 is more soluble.

25

What is the original protein that is cut to form both amyloid-beta 42 and beta-amyloid 40?

APP - amyloid precursor protein

26

What stabilizes microtubules inside a neuron?

Hyperphosphorylated tau protein.

27

What is the cholinergic hypothesis for Alzheimer's?

That the loss of cholinergic neurons is responsible for AD. This is now considered a downstream event (aka something is killing these neurons, causing AD).

28

What is the amyloid-beta hypothesis? What is wrong with this hypothesis?

A-beta is the initial pathology leading to inflammation and neuronal death. However, almost all adults have A-beta, and A-beta load does not correlate with AD symptoms.

29

What is Tau Hypothesis?

Tau-hyperphosphorylation and neurofibrillary tangles is the single common pathway that leads to PD. Tau hypothesis is gaining ground as the predominant hypothesis.

30

What is the inflammation hypothesis?

Inflammation is a common event in AD. Nonspecific inflammation damages neurons causing A-beta and NFT (Neurofibrillary tangles). Many believe this is a marker of neuronal damage rather than the cause.